Open fetal surgery for myelomeningocele

Michael W. Bebbington, Enrico Danzer, Mark P. Johnson, N. Scott Adzick

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations


Despite efforts at prevention through the use of preconception folic acid, spina bifida remains one of the most common congenital anomalies of the central nervous system that is compatible with life. It is, however, associated with a significant degree of lifelong morbidity. The development of open fetal surgery for myelomeningocele (MMC) has been a long process but one that serves as a model for how new procedures and technologies need to be properly evaluated before being brought into mainstream medical practice. Even so, risks and benefits need to be evaluated for each patient. The currently available studies have been carried out on a highly selected patient population where the fetal findings provided the maximum opportunity for benefit from prenatal closure of the MMC defect. There is the potential that as the surgery becomes more widely available, pressure will be brought to bear to perform surgery in cases where the likelihood for benefit is decreased and yet the risks are not. The only way to duplicate the results of the current studies is to follow the methodology and criteria that were used in the studies. This will mean that not every fetus with an MMC will be a candidate for in utero surgery. The balance of risk to benefit will continue to evolve as further technological advances are evaluated and more follow-up information is obtained.

Original languageEnglish
Pages (from-to)689-694
Number of pages6
JournalPrenatal Diagnosis
Issue number7
StatePublished - Jul 1 2011


  • Fetal surgery
  • Myelomeningocele
  • Pregnancy outcomes
  • Spina bifida


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